World’s Poor Pharma

In this column, Martin Khor, executive director of the South Centre, writes about Yusuf Hamied, co-owner, managing director and leading personality of Cipla, one of Indias biggest generic drug companies. He describes Hamied as the man who arguably has done more than anyone else in the world to save millions of lives of people with AIDS and other diseases.

MUMBAI, Mar 19 2013 (IPS) - I recently spent a day in Mumbai with the man who arguably has done more than anyone else in the world to save millions of lives of people with AIDS and other diseases.

Martin Khor. Credit: Nic Paget-Clarke.

Yusuf Hamied, the co-owner, managing director and leading personality of Cipla, one of India’s biggest generic drug companies, is most unusual. Ideas and words flow from him like a mighty river, as he moves from one topic to another.

This seems to come from the combination of a brilliant scientific mind (he has a PhD in Chemistry from Cambridge), a passion to overcome injustice and do good for the poor, skills to turn ideas into practical results, and the business imperative to make money at the same time.

Hamied is the major driving force in making high-quality HIV/AIDS antiretroviral medicines cheap enough that the poor in developing countries, especially in Africa, can access them.

In the process, he and a network of health activists and international organisations had to confront an entrenched system where a few drug multinationals, backed by patents, monopolised the AIDS medicines market.

Treatment once cost 12,000 to 15,000 dollars per patient per year. But Hamied combined three antiretrovirals into a single pill called triomune, making it easier and more effective for patients to take, and offered it at the rate of 350 dollars a patient per year.

That was in 2001, and his announcement caused acute anxiety for the drug multinationals who called him a “pirate”. But he also evoked great excitement and hope among AIDS patients and their support groups around the world. To them, he is a Robin Hood.

Evidence shows many lives have been saved or prolonged due to the medicines, 85 percent of which come from Indian companies. But since there are almost 40 million people worldwide suffering from AIDS, much more needs to be done.

Hamied is now turning his attention to cancer. Last year Cipla slashed prices of three generic anticancer drugs by up to 75 percent. “The time has come to…provide affordable medicines for cancer, as we did for AIDS medicines,” he says.

In the case of one cancer drug, sorafenib, the original patented product by Bayer had cost 5,091 dollars for a month’s treatment, way beyond the means of Indian patients. Another Indian company, Natco, obtained a compulsory licence and sold its generic version for 160 dollars, while Cipla last year cut the price of its own version to 124 dollars.

Hamied is also on top of the latest science on other diseases, and seeking solutions to a host of health problems.

When I asked him about the anticipated bird flu epidemic of a few years ago, about the spread of drug-resistant malaria, and the threat of multiple-drug-resistant tuberculosis, Hamied responded each time with his attempts, past and present, to make generic drugs available.

He gave me a scientific paper on a particular drug that he thinks is the best chance of tackling the deadly resistant forms of TB, indicating he is exploring how to produce it.

It has made its mark as a champion of generics, fired with a nationalist and self-reliant spirit sparked by Mahatma Gandhi, who visited this same Cipla office in 1939. He requested the then owner, K.A. Hamied (Yusuf’s father), to initiate the local manufacture of medicines due to shortages caused by the onset of the war in Europe.

Hamied sees several looming problems that may cloud the future of the Indian industry.

The first is the 2005 introduction of product patents in India, in line with the World Trade Organisation’s (WTO) rules. Local companies now require a compulsory licence from the government to produce generic versions of new medicines that are patented.

“It is a very cumbersome process to apply for and get a compulsory licence for each patented medicine,” he says. “What is needed is a system of automatic compulsory licencing, with payment of four percent royalty to the patent owner.”

Canada and India had such a system in the past, and this should be revived, as India and other developing countries cannot afford to have monopolies and high prices in medicines.

Second are the free trade agreements (FTAs) that several developing countries, including India, are negotiating with Europe or the U.S. Hamied points out that these FTAs contain clauses that would seriously hinder or stop the production of new generic medicines in those countries that sign the agreements.

Third is the need to produce active pharmaceutical ingredients (APIs), which are the essential materials in the medicines. While many countries are able to make the finished products in the forms and dosages required, only a few developing countries (India and China principally) have the ability to make the APIs.

Hamied warns that India is already making less of the APIs than its industry needs, and an over-reliance on imports is developing. “If China and India don’t supply APIs to the world, the world pharmaceutical industry may face collapse.”

According to Hamied, India also needs a better drug pricing policy and a more efficient drug regulatory system as there are many new generic medicines in the queue for safety clearance but lately there has been a long delay in decisions.